Novel Endoscopic Therapy for the Treatment of Pill induced Esophageal ulcer

Abstract

Background and aims; The available therapy for retrosternal
pain and dysphagia associated with pill induced esophageal ulcer
are only partially effective in relieving symptoms and no specific
treatments have been shown to be beneficial in altering the
course of medication induced injury. Our aim of the study is to
assess the safety and efficacy of endoscopic injection of Lignocaine
hydrochloride for the relief of retrosternal pain and dysphagia
in cases of pill induced esophageal ulcer(s). Patients and
methods; From March 2000 to March 2006, 17 patients of pill
induced esophageal ulcer who did not respond to conventional
treatment underwent endoscopic injection of Lignocaine hydrochloride
using sclerotherapy needle in and around the pill
induced esophageal ulcer(s) to relieve retrosternal pain and
dysphagia. Relief of retrosternal pain and dysphagia with reference
to Visual analogue scale (VAS) score and dysphagia grading
respectively were scored by blinded examiners before and
after treatment. Results: Of the 17 patients, 15 patients got immediate
and complete relief of symptoms after the first session
of injection and 2 patients had relief of dysphagia from grade 4 to grade 1- 2 after the first session of injection and appreciated complete relief of symptoms (dysphagia grade 0) after the second session of injection given 4 days later the first session of injection. There was significant change in VAS score before and after injection of Lignocaine hydrochloride (p<0.0001).
Conclusions:
The endoscopic injection Lignocaine hydrochloride in and
around the pill induced esophageal ulcer(s) for the relief of odynophagia
and retrosternal pain is safe and effective.